Riomet

The active ingredient in Riomet is metformin hydrochloride. It belongs to a class of medications called biguanides.

Metformin works by helping your body use insulin more effectively. It lowers the amount of sugar produced by your liver and decreases the absorption of sugar from your intestines. Together, this helps reduce high blood sugar levels (hyperglycemia) and improve hemoglobin A1c (HbA1c) from baseline and improve fasting plasma glucose (the amount of sugar in your blood when you wake up).

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Riomet.

• However, the following is a synopsis of the general guidelines for the use of Riomet:
• Riomet is a liquid oral solution, not a tablet. Always measure your dose with the supplied measuring cup or oral syringe. Do not use household spoons.
• Riomet should be taken with food to reduce stomach side effects such as nausea or upset stomach.
• The maximum daily dose of Riomet is 2,550 mg (25.5 mL). Do not exceed the maximum dose.
• Check your blood glucose levels regularly as instructed.
• Stay hydrated while taking Riomet. Dehydration increases your risk of lactic acidosis, a rare but serious side effect.
• Avoid drinking alcohol, as this can raise your risk of developing lactic acidosis or severe dizziness.

If you are taking other blood sugar–lowering drugs such as insulin or glyburide, monitor for symptoms of low blood sugar such as shakiness, confusion, hunger, or sweating. If your blood glucose is below 70 mg/dL (4 mmol/L), take 15 grams of fast-acting sugar such as glucose tablets or juice and re-check your blood sugar after 15 minutes.

Some mild or common side effects compared to placebo include:

• Diarrhea.
• Nausea or upset stomach.
• Stomach pain or discomfort.
• Gas or bloating.
• Headache.
• Metallic taste in the mouth.

Some individuals may experience serious side effects while using Riomet. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Severe allergic reaction with swelling of the face, lips, tongue, or throat, rash, or difficulty breathing.
• Symptoms of lactic acidosis, a rare but serious condition caused by a buildup of lactic acid in the blood. Warning signs include unusual tiredness, muscle pain, severe stomach pain, shortness of breath, or feeling cold.
• Severe hypoglycemia (low blood sugar) may occur if used together with insulin or other diabetes medications.
• Low vitamin B12 levels with long-term use, which can lead to weakness, fatigue, pale skin, or numbness and tingling in the hands or feet.

These are not all of the possible side effects of Riomet. Always seek medical advice from your healthcare provider about any side effects or symptoms you experience. Read all patient information that comes with the medication. You can also report side effects to the Food and Drug Administration (FDA) at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Riomet, it is crucial to discuss any existing health conditions with your healthcare provider. Tell your doctor if you have or have ever had:

Kidney disease.

Liver disease or heavy alcohol use.

Cardiovascular disease, including congestive heart failure or a history of heart attack.

Recent surgery or serious infection.

Vitamin B12 deficiency or anemia.

Plans for an X-ray or imaging test that uses contrast dye.

Dehydration or conditions that cause low oxygen, such as severe lung disease.

If you are 65 years of age or older.

Pre-menopausal - Riomet may stimulate ovulation and cause unintended pregnancy.

Severe kidney disease

Metabolic acidosis

Diabetic ketoacidosis

Known hypersensitivity to metformin or any inactive ingredients in the formulation

Riomet starts working soon after your first dose, helping to lower your blood sugar within a few days. However, it may take up to 2 to 3 months to see the full improvement in your hemoglobin A1c (HbA1c) levels and overall glycemic control.

When Riomet is taken with other prescription drugs, over-the-counter medications, vitamins, or supplements, it may change how they work or increase the risk of side effects. Tell your healthcare provider about everything you take.

Common drug interactions include:

• Cimetidine, ranolazine, and dolutegravir may increase the amount of metformin in your blood and raise the risk of lactic acidosis
• Carbonic anhydrase inhibitors such as topiramate or zonisamide can increase the risk of metabolic acidosis
• Insulin or sulfonylureas such as glyburide can increase the risk of low blood sugar
• Alcohol, which raises the risk of lactic acidosis and dizziness
• Beta-blockers (propranolol, metoprolol) can reduce your blood pressure/ heart rate, and make it harder to notice signs of low blood sugar.
• X-ray contrast dyes may cause sudden changes in kidney function. Your doctor may stop Riomet before and after your imaging test.
• Furosemide and nifedipine, which may alter how metformin is absorbed or eliminated

Always check with your doctor or pharmacist before starting or stopping any new medications or supplements.

Riomet is available as an oral solution containing a 500 mg dose of metformin hydrochloride per 5 mL.

It should be stored at room temperature out of the reach of children or pets.

Riomet is manufactured by Ranbaxy Laboratories Limited, now part of Sun Pharmaceutical Industries.

Yes, it is available from many manufacturers of generic drugs. Metformin is also available in other dosage forms, such as an extended-release tablet and oral suspension.

Barring any serious side effects as listed above, or under the direction of a physician, you should not stop this medication suddenly.

If you are pregnant or planning to become pregnant, talk to your doctor.

Metformin does cross the placenta, but studies suggest it is not linked with major birth defects. However, your doctor will decide whether to continue Riomet or switch to another treatment, such as insulin, depending on your condition and blood sugar goals.

Proper blood glucose control during pregnancy is essential to reduce the risk of complications for both mother and baby.

Metformin passes into breast milk in small amounts during lactation. Studies suggest that the amount is too low to harm a nursing infant, but information is limited.

Talk to your doctor if you are breastfeeding or planning to breastfeed. Your healthcare provider will weigh the benefits of controlling your diabetes with Riomet against any potential risks to your baby.